Public domain of other people's pain is debated

By Elizabeth Allen - Express-News

Published
12:00 am CDT, Saturday, May 8, 2010

If you write about someone else's pain, does it then belong to you, or to that person?

Physician and author Jerald Winakur struggled with that question as he wrote of an aging couple — patients of his — whose lives ended in murder-suicide. He wrote of the couple's personal interactions, their health problems and strained relationship with their daughter.

Winakur dealt with it by changing their names and many details of their lives.

“But why? It was a murder-suicide. It was a public record,” said writer Phillip Lopate.

Winakur gained prominence by tackling the issue of aging parents in an essay, “What are we going to do with Dad?” that evolved into the book “Memory Lessons.”

Winakur concluded that respect for the confidentiality of the doctor-patient relationship is crucial. But when any writers publish, particularly when they're professionals, “you do have a responsibility to those whom you write about, if it's identifiable, to get appropriate informed consent.”

Lopate is less gentle.

“I don't think they own it, no. It sounds harsh, but it's not their material anymore,” he said.

Lopate has written about his own family, describing his mother's affair and his father's self-definition as a failure. He said he doesn't take the view that all material is fair game, and he's been less specific about his siblings' lives. But he dismisses the concept of ethical purity.

“It has helped me personally to think of myself — that I'm not entirely a nice guy,” Lopate said. But even that, he said, is a rationalization.

At first Lopate's mother was pleased that he wrote about her, he said. “Now I know you love me,” she told him. But after he wrote more, she decided she'd had enough. Lopate did not stop.

“She was too good a character. I couldn't give her up,” he said.

He also disagreed with changing details to disguise identities.

“Once you start doing that, the charm of reality starts seeping out.”

Winakur disagrees.

“I think that might be true in the kind of writing that Phil does, which is literary nonfiction. But in what I do, I'm really aiming at presenting ethical dilemmas through story,” Winakur said, “and I don't feel that I'm losing the essence of the ethical dilemma by making those kinds of changes.”

Winakur said he changed this couple's name because he had lost touch with the daughter, but for living patients he always asks for consent. Nobody as yet has said no. Another doctor he knows shows her work to the patients, and said they have even found it therapeutic.

Lopate called that “dicey,” warning that it could set up a manipulation of the patient/subject, and self-deception for the doctor, who appears to take the high moral ground.

“There's no one thing you can do that will get you ethically clean, so give it up,” he said.

Winakur used the elderly couple, he said, because they were a powerful story in his life and a lesson for others.

While the two writers agreed that is a basic purpose of literature, Lopate disagreed that Winakur had a greater obligation to his patients than Lopate had to his parents.

“He's writing about an area of life that's very important: illness, life and death, but he has to go through the same excavation of his own thoughts, his own motives,” Lopate said.

Writers must pay a price of their own, he said, if they want to write well.